ADVICE FOR CARERS OF YOUNG CHILDREN PRESENTING THE THE THREE COMMONEST CHILDHOOD CONDITIONS
Earache
Earache is a sudden and painful condition. It often, but not always, occurs when a child has a cold and often wakes the child up in the middle of the night.
The first and most effective step is to use a safe pain killer, namely paracetamol (calpol, medised, disprol etc.) in adequate amount.
Give the child a first dose which is double that stated on the bottle for that child's age. For example, if the dose stated is 5 ml every four hours you can safely give 10 ml for the first dose, providing the child has not had the total allowance of paracetamol for that day anyway. Similarly, one further double dose can be given 4 hours later.
A "warm" hot water bottle may also help. There is no immediate need for any other treatment.
You should then make an appointment for the child to be seen by the doctor at the surgery to check whether antibiotics are needed.
Fever/High Temperature
Many kinds of illnesses can give a child a fever, for example ear infections, tummy bugs or virus infections as well as some of the more serious conditions, e.g. Meningitis.
The most important thing is to lower the child's temperature in the following three ways:-
1. Sponge the child down with tepid water on a flannel.
Keep sponging the child' s head until the hair is wet, and
remains wet. The head is the area from which heat can be
lost most effectively. Also sponge the face, neck, upper chest
and back every ten minutes or so.
2. Give the child as much fluid as you can - anything they
like would e.g. Ribena, squash etc.
3. Use paracetamol (calpol, medised, disprol etc.) as above.
Remember that you can start by using a double dose as
you have still not exceeded the full 24 hour maximum
dose.
If the temperature persists and the child remains unwell for more than 12 hours, then you must seek advice from your doctor. ( If the child gets worse even though you have followed the above advice you must seek advice sooner). Also, remember it does the child no harm whatsoever to take them well wrapped up to the surgery with a temperature - indeed, the fresh air may help lower the temperature more.
Diarrhoea and Vomiting
The commonest cause is usually a tummy bug which does not need specific treatment as the body will naturally get rid of it. However, the child may lose a lot of fluid. This will make the child feel unwell so you should -
1. Stop all forms of solids and any milky foods or drinks.
2. Offer the child his or her favourite sugary drink (not water alone) eg. Ribena, orange squash, etc. Only give in small tablespoonful amounts every 10 minutes or so.
It is important not to offer more than this to begin with as small amounts are absorbed very quickly. Larger amounts could make the child vomit again.
Be cruel to be kind! Allow only a tablespoon every 10 to 15 minutes.
3. If the child has a fever with the tummy bug you can use paracetamol (calpol, medised, disprol etc.) as above.
When the child is able to keep these fluids down you may offer a little more but continue to offer the clear and sugary fluids (not water) for the first 24 hours.
On the second day, you can gradually introduce dry toast, boiled rice, boiled chicken or boiled fish.
On the third day, reintroduce the normal diet.
If the diarrhoea persists despite the above measures make an appointment to see your doctor to decide if a stool sample needs to be sent to hospital for analysing.
If the vomiting does not stop within the first 24 hours or the child deteriorates, you must seek advice from your doctor.
Dr. George Boulos, M.B., B.S.(London),L.R.C.P.(London),M.R.C.S.(England), M.R.C.G.P.,
Associate Teacher in General Practice
St. Mary's Hospital Medical School, London
G.P. Tilehurst Surgery, Reading